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General NPI Number Information
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NPI Number | 1669344032
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Entity Type | Individual
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Provider Name | HANNAH LYNN GOERKE
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Gender | Female
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Dates
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Enumeration Date | 09/23/2025
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Last Update Date | 09/23/2025
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Provider Practice Location Address
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Address Line | 2079 ORANGE TREE LN
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City | REDLANDS
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State | CA
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Zip | 92374-2849
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Country | US
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Telephone | 909-353-7053
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Fax |
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Provider Business Mailing Address
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Address Line | 12168 MOUNT VERNON AVE UNIT 39
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City | GRAND TERRACE
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State | CA
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Zip | 92313-5542
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Country | US
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Telephone | 574-276-8352
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 308839
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License Number State | CA
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